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Pulmonology Coding Alert

CPT® Coding Strategies:
Simplify Your Vaccine Administration Reporting With This Expert Advice
Hint: Follow totally different reporting system for Medicare patients. When your pulmo... Read more
Compliance:
Don't Falter On Your E/M Reporting By Failing To Catch These Clues
Don’t invite yourself for audits by overlooking these common errors. If you&rsqu... Read more
ICD-10 Update:
Distinguish Byssinosis Diagnosis Distinctly With J66.0
Hint: Look for other expansions to J66 for pneumopathy due to inhalation of other dusts.... Read more
Reader Question:
Sort Out Same Session 99407 and E/M Mix-ups
Question: I am billing 99407 with 99213 and getting denials. I have used the modifier 25... Read more
Reader Question:
Here's When to Use 95803 as a Standalone Code
Question: I am new to pulmonology coding and our pulmonologist performs many sleep study... Read more
You Be the Coder:
Avoid Confusion Over Lavage and Cell Washing Reporting
Question: Bronchoscopy dictation states, “copious amounts of mucopurulent, brownis... Read more
CPT® 2014 Update:
Factor In New E/M and Chest Wall Oscillation Codes in 2014
In addition: Don’t forget the new Category II codes added for PQRS measures. Whe... Read more
Back to Basics:
Employ The 3-Year Rule To Accurately Report New/Established Patient E/M Codes
Hint: Place of service won’t influence the patient status. To accurately report ... Read more
ICD-10 Update:
Define Your Lymphoid Interstitial Pneumonia Diagnosis With J84.2
Good news: You no longer need separate diagnosis codes for known and idiopathic causes. ... Read more
Reader Question:
Zero in on Clues in Patient Documentation to Report Appropriate Laryngoscopy Code
Question: Our pulmonologist recently performed a laryngoscopy during which he removed a ... Read more
Reader Question:
Report Sleep Studies Based on Parameters Recorded
Question: Our pulmonologist recently performed ResMed Type II home sleep study, giv... Read more
You Be the Coder:
Avoid Modifier 51 For Multiple Endoscopies Unless Payer Rules Mandate it
Question: Our pulmonologist recently assessed a patient who he had diagnosed with lung a... Read more
CPT® 2014 Update:
Look for Consult, Vaccine, PFT Code Additions Next Year
Good news: TCM services can now be applied to new patients too.  The earlier you... Read more
Key Elements:
Keep Your Pay Flowing by Selecting the Most Appropriate E/M Guidelines
Hint: You can vary between the two E/M guidelines for each encounter. If choosing betw... Read more
ICD-10 Update:
Identify Suberosis Diagnosis With J67.3 in ICD-10
Hint: Use same diagnosis code if your clinician diagnoses cork-handler’s disease. ... Read more
Clip and Save:
Keep This Chart Handy to Determine Exam Levels Accurately
Select the guidelines that will carry the best advantage to your coding. With two sets... Read more
Reader Question:
Watch Out For Instances to Separate Same Day Office and E/R Visits
Question: If a patient was seen for an office visit (99214) first and then later on the ... Read more
Reader Question:
Understand How Vital Signs Contribute to Physical Examination
Question: Would you please explain how taking the vital signs contribute to determining ... Read more
You Be the Coder:
Avoid Confusion Over Reporting Xolair Administration
Question: I know there are articles that state you can use ‘96401’ for Xolai... Read more
CCI 19.2 Update:
Watch for E/M Service Bundles With Pulmonology Procedure Codes
Focus: Bundles affect pulmonary function tests with coronary procedures. If you’... Read more
Money Matters:
Need Cash? Know How You Can Boost Your PQRS Bonus Ethically
Hint: Base your decisions by analyzing the number of providers in your group. If you h... Read more
ICD-10 Update:
Enjoy Distinct Reporting Options For Hemothorax
Hint: Use same ICD-10 code if the diagnosis is hemopneumothorax. When your pulmonologi... Read more
Reader Question:
Don't Report 496 For Specified COPD Diagnosis
Question: Our pulmonologist recently diagnosed a patient to be suffering from Emphysema/... Read more
Reader Question:
Don't Forget to Report Chest Drain Placement Separately For Pleurodesis
Question: Our pulmonologist recently performed right-sided chemical pleurodesis with dox... Read more
Reader Question:
Don't Deviate From EOB Specifics or You Might Land up in a Soup
Question: We have a patient who wants us to directly bill her allowable charges for a pr... Read more
You Be the Coder:
Check Ventilation Type to Choose The Appropriate Reporting Option
Question: What is the correct CPT® for the following: BIPAP EZPAP E... Read more
CPT® Coding Tips:
Hit The Spot on Fiducial Marker Placement Reporting With This Guidance
Hint: Don’t forget to check for any  separately reported guidance. When you... Read more
Key Elements:
Ignoring PFSH Details Will Set You Back by More Than $70 Per Encounter
Hint: Don’t neglect history captured in previous visits to complete your PFSH. W... Read more
ICD-10 Update:
Get Set For One-to-One Transition For Inhalation Pneumonitis
Hint: Don’t forget to code the inhaled substance separately with an appropriate T ... Read more
Reader Question:
Use Different Codes for Home Sleep Tests Depending on Payer
Question: I have a physician who will begin to do Home Sleep Studies shortly. I need hel... Read more
Reader Question:
Cue Into the Right Method of Billing Out EBUS With TBNA
Question: Can you please tell me the exact sequence and modifier (if necessary) as to ho... Read more
You Be the Coder:
Segregate Components of a Spirometry For Interpretations
Question: I am new to pulmonology coding. I see there are many different codes to report... Read more
CPT® 2013 Coding Strategies:
Add Age Criteria to Old Parameters For Accurate PSG Reporting
Hint: Watch for appropriate modifier usage if time requirements are not met. When your... Read more
CPT® Coding Tips:
Breathe a Sigh of Relief: Follow This Guide to Successful Inhalation Treatment Reporting
Hint: Don’t forget to report any prior E/M services separately. When your pulmon... Read more
ICD-10 Update:
Factor In a Separate Diagnosis Code For Atelectasis
Hint: Don’t report newborn atelectasis or tuberculous atelectasis using J98.11. ... Read more
Reader Question:
Check CCI Prior to Reporting Other Procedures with E/M or Critical Care
Question: Please show us the best way to bill this claim. We have this type of claim oft... Read more
Reader Question:
Reporting CPAP Separately With E/M? Think Again
Question: Our pulmonologist recently provided E/M services and also performed ventilatio... Read more
Reader Question:
Know What to Do if Your Patient Doesn't Honor the ABN
Question: We have a patient who came for a service we knew Medicare wasn’t likely ... Read more
You Be the Coder:
Count Lobes, Not Sites When Reporting TBNA Procedures
Question: My physician is billing for a transbronchial needle aspiration (TBNA) in the r... Read more
CPT® 2013 Coding Strategies:
Zero In On The Right Bronchial Thermoplasty Code With This Advice
Hint: Check the necessity of prior authorization to avoid payer denials. Counting the ... Read more
Key Elements:
Crosscheck ROS Documentation to Capture Higher Level E/M Opportunities
Hint: Guide your clinician to complete documentation of review of systems. Ensuring yo... Read more
ICD-10 Update:
Look For Easy Crossover to J82 For Pulmonary Eosinophilia
Hint: Pulmonary infiltrates NOS should be reported with a different code as in ICD-9. ... Read more
Reader Question:
Append Modifiers When Time Requirements for Polysomnography Aren't Met
Question: If polysomnography test was started, but after 15 minutes has to be stopped, b... Read more
Reader Question:
Factor Peak Flow Measurements as Part of E/M Service
Question: Can 94150 be billed for peak flow measurement alone without total vital capaci... Read more
Reader Question:
Note That Immunization by MA Doesn't Usually Qualify for E/M
Question: This is the first year we are considering providing FluMist without a physicia... Read more
You Be the Coder:
Check Necessity of Modifier to Separate Components of PFT
Question: Can you bill ‘94620’ along with a full PFT, codes ‘94060&rsq... Read more
CPT® 2013 Coding Strategies:
Clear the Way to Accurate Bronchial Valve Reporting With This Advice
Hint: Obtain prior authorization to avoid payer denials. To correctly report the new C... Read more
Observation Care Strategies:
Boost Reimbursement Through Precise Timekeeping for Observation Care Services
Hint: Use the CMS time rules to avoid confusion while counting minutes. As a pulmonolo... Read more
ICD-10 Update:
J80 Choices Upgrade Your Acute Respiratory Distress Syndrome Dx
Hint: ARDS in the newborn should be reported with a different code as in ICD-9. When y... Read more
Reader Question:
Billing G0424 for Non-COPD Patients? Not so Fast
Question: We currently bill for pulmonary rehab using a G0424. We have recently been que... Read more
Reader Question:
Check Payer Policies When Billing Incident-to Services
Question: If one of our NP’s does an intubation or other procedure and the physici... Read more
Reader Question:
Base Principal Diagnosis on DRG Weight
Question: A patient was admitted with a chief complaint of shortness of breath. He also ... Read more
Reader Question:
Avoid Confusion Over POS For Radiology Procedures
Question: One of my coworkers heard that some Medicare rules have changed regarding whet... Read more
You Be the Coder:
Don't Report Same Lobe Biopsies With +31632
Question: Our pulmonologist recently performed a bronchoscopy on a patient. During the p... Read more
CPT® Coding Update:
Ensure Correct Thoracentesis/Pleural Drainage Reporting With This Advice
Hint: Imaging guidance is the final key to precise code selection. To accurately repor... Read more
Appeal Strategies:
Use this 4-Step Strategy For Successful Modifier 25 Claims
Maintain list of payers that deny these claims to help re-negotiate contracts. Many pa... Read more
ICD-10 Update:
Get Set For Broader Reporting Options For Acute Respiratory Failure
Hint: Post-procedural respiratory failure should still be reported differently as in ICD... Read more
Identify Hypercapnia and Hypoxia in Documentation
The key to identifying the presence of hypoxia or hypercapnia is looking at the results ... Read more
Reader Question:
Base 30-Day Spirometric Recording Reporting on Professional/ Technical Components
Question: Our pulmonologist recently reviewed results of a patient induced spirometric r... Read more
Reader Question:
Check Insertion Method For Apt Reporting of Fiducial Markers
Question: Our pulmonologist recently diagnosed a patient with lung cancer. To enable rad... Read more
Reader Question:
You Could Be Penalized for Illegible Documentation
Question: I have heard payers are cracking down on illegible provider documentation. My ... Read more
You Be the Coder:
Reporting Multiple Units of 31625 For Multiple Biopsies/ Sites? Watch Out
Question: Our pulmonologist recently performed a bronchoscopy on a patient. During the p... Read more
CCI 19.0 Update:
Caution: Pay Heed To Polysomnography Sleep Study Bundling
Hint: Check modifier indicators to know when a recorded parameter can be unbundled. As... Read more
Documentation:
Watch For Cloned E/M Documentation or Suffer OIG's Scrutiny
Always crosscheck your EMR entries to avoid unnecessary surprises. If your documentati... Read more
ICD-10 Update:
J12 Provides Increased Options For Reporting Viral Pneumonia
Watch out for descriptor changes to codes in ICD-10. If your pulmonologist arrives at ... Read more
Reader Question:
Base Fluid Removal on Method and Intent of Treatment
Question: Can I use 32554 when our pulmonologist performs a diagnostic thoracentesis or ... Read more
Reader Question:
Use Month to Determine Birthday Rule
Question: We recently made a claim for services provided to a minor patient by billing h... Read more
Reader Question:
No Insurance Card? Here's What to Do
Question: How should I handle a patient who has new coverage but has not received an ins... Read more
You Be the Coder:
Reporting Imaging Guidance Separately With Thoracentesis? Think Again
Question: Can physician bill 76942-59 with 32555 when done in hospital or is it bundled ... Read more
CCI 19.0 Update:
Stay Alert For Bundles Affecting Newly Introduced Pulmonology Codes
Hint: Watch modifier indicators when reporting with laryngoscopy procedures. As you be... Read more
2013 Payment Update:
Breathe Easy As Congress Reverses Medicare Pay Cut For 2013
AMA pushes for a more permanent resolution. If you were wondering how you’d scra... Read more
CPT® 2013 Update:
Check Out How Addition of TransitionalCare Codes Will Affect You
Understand the nuances of terminology changes to other E/M codes. When you begin using... Read more
ICD-10 Update:
Enhance Your Acute Bronchiolitis Reporting Using J21 in ICD-10
Hint: Causative organism is still the basis for selecting the code as in ICD-9. When y... Read more
Brush Up on Your MUE Facts
Here’s the lowdown on Mutually Exclusive edits from CMS. "The Mutually Excl... Read more
Reader Question:
Know When to Capture Pleural Effusion Separately With Anasarca
Question: The diagnosis for one of the patients admitted to our facility was anasarca wi... Read more
Reader Question:
Pay Heed to CCI Bundling When Reporting PFT Procedures Together
Question: We billed a patient who underwent PFT and inhalation test with albuterol with ... Read more
Reader Question:
Turn to Modifier Q6 For Locum Tenens NP Supervision
Question: One of our pulmonologists will be away for ten weeks. He has made locum tenens... Read more
You Be the Coder:
Remember That 94762 is an Exclusive Technical Component Code
Question: Can you bill for 94762 when a patient uses an overnight oximetry and returns i... Read more
CPT® 2013 Update:
You Now Have More Choices for Your PSG and Allergy Testing Reporting
Don’t forget to take into account descriptor changes to old code sets. When your... Read more
CPT® 2013 Errata:
Don't Let These CPT® Errata Slip Past You
Get set to mark your coding manual with these changes. If you have been checking out y... Read more
CPT® 2013 Update:
Update Your 2013 Vaccine Coding With These Adjustments
Plus: Also watch out for these new options that won’t be in the CPT® book yet.... Read more
ICD-10 Update:
Shift to J04.0 For Acute Laryngitis in ICD-10
Don’t forget to take into account the number of conditions the code will represent... Read more
Reader Question:
Don't Forget 5th Digit Code For TB Diagnosis
Question: Is the ICD9 code for extra-pulmonary TB 011.8(fifth digit)? The documentation ... Read more
Reader Question:
Eliminate Same Day Physician and NP Services Billing Confusion
Question: Our NP is working with our pulmonologist in the same outpatient clinic. We are... Read more
You Be the Coder:
Choose Drug Code Based on Strength
Question: I need a code for the drug Depomedrol? I was told it’s the same as Kenol... Read more
Available Years:  2013  2012  2011  2010  2009  2008  2007  2006  2005  2004  2003  2002  2001  2000